Drug interactions
Bosentan + Ethinyl estradiol-levonorgestrel
Severity: Major
Bosentan and Ethinyl estradiol-levonorgestrel: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Bosentan lowers hormonal contraceptive concentrations and may cause contraceptive failure. This matters because bosentan is teratogenic.
What this interaction means in plain words
Bosentan and Ethinyl estradiol-levonorgestrel can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Bosentan belongs to Miscellaneous; Ethinyl estradiol-levonorgestrel belongs to Endocrine.
Why it happens
CYP3A4 induction by bosentan increases metabolism of ethinyl estradiol and levonorgestrel.
What to do
Do not rely on hormonal contraception alone; use an IUD or combine two other methods as required by bosentan labeling.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Ethinyl estradiol-levonorgestrel
- Ethinyl estradiol-levonorgestrel + Fezolinetant Contraindicated
- Ethinyl estradiol-levonorgestrel + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Ethinyl estradiol-levonorgestrel + Tranexamic acid Contraindicated
- Aminocaproic acid + Ethinyl estradiol-levonorgestrel Major
- Amobarbital + Ethinyl estradiol-levonorgestrel Major
- Anastrozole + Ethinyl estradiol-levonorgestrel Major
Other interactions of Bosentan
- Bosentan + Cyclosporin Contraindicated
- Bosentan + Glibenclamide Contraindicated
- Bosentan + Glyburide-metformin Contraindicated
- Bosentan + Lonafarnib Contraindicated
- Bosentan + Sparsentan Contraindicated
- Artemether / lumefantrine + Bosentan Major
Frequently asked questions
Can I take Bosentan with Ethinyl estradiol-levonorgestrel?
MediHelp rates the interaction as major. Bosentan and Ethinyl estradiol-levonorgestrel can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Bosentan lowers hormonal contraceptive concentrations and may cause contraceptive failure. This matters because bosentan is teratogenic.
How serious is the interaction between Bosentan and Ethinyl estradiol-levonorgestrel?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not rely on hormonal contraception alone; use an IUD or combine two other methods as required by bosentan labeling.
What other medicines interact with Ethinyl estradiol-levonorgestrel?
MediHelp also lists interactions of Ethinyl estradiol-levonorgestrel with, for example, Fezolinetant, Ombitasvir / paritaprevir / ritonavir and dasabuvir, Tranexamic acid. The full list is on the Ethinyl estradiol-levonorgestrel page.
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